Usefulness of coronary angiography in the assessment of coronary artery calcifications and its comparison with intravascular ultrasound

The IVUS (intravascular ultrasound) and angiographic assessment of coronary arteries were performed in 127 patients (98 male). The aim of the study was to establish the sensitivity of coronary angiography in diagnosing coronary calcification comparing with intracoronary ultrasound. Based on angiography, 322 coronary segments were defined. Depending on the level of lumen stenosis, segments were divided into 3 groups: without angiographically visible stenosis, with up to 50% stenosis, and over 50% stenosis. In all segments, the presence of calcifications was assessed by both methods: angiography and IVUS. It was found that the average sensitivity of angiography in coronary calcium detection as compared to IVUS was 32%. It was also affirmed that the sensitivity of an X-ray examination for detection of calcifications depends on the magnitude of calcifications. The sensitivity is low for calcifications occupying one (3%) and two (32%) quadrants of ultrasonographic artery cross section circumference, and high for calcifications occupying three (80%) and four (100%) quadrants of ultrasonographic artery cross section circumference. Calcifications were rarely found in angiographically normal segments, but more often in segments with up to 50 % stenosis, and most often in segments with significant angiographic stenosis. (author)